Comments on: Healthcare Update Satellite — 05-21-2014http://www.epmonthly.com/whitecoat/2014/05/healthcare-update-satellite-05-21-2014/
A blog from inside the emergency departmentThu, 26 Mar 2015 23:22:27 +0000hourly1http://wordpress.org/?v=4.1.1By: Dorothyhttp://www.epmonthly.com/whitecoat/2014/05/healthcare-update-satellite-05-21-2014/#comment-159034
Fri, 06 Jun 2014 00:41:48 +0000http://www.epmonthly.com/whitecoat/?p=9793#comment-159034Who’s got the government contract for lung cancer screening? I’m sure they feel it’s worth it, even if it saves only one life. Completely worth it.
]]>By: WhiteCoathttp://www.epmonthly.com/whitecoat/2014/05/healthcare-update-satellite-05-21-2014/#comment-156741
Thu, 29 May 2014 21:22:28 +0000http://www.epmonthly.com/whitecoat/?p=9793#comment-156741I’m glad that you’ve had good experiences and I certainly wouldn’t contend that everyone who gets care at the VA is getting shafted.
However, there is a culture in the VA system and in the private sector that needs a serious overhaul. Little if any competition. No incentive to do better other than intrinsic desire. Sometimes disincentive to do better if it involves spending too much money or exposing corruption. That culture isn’t going to change by creating a law forcing people to pay money to third party insurance companies who then have an incentive to deny care in order to pay multi-million dollar bonuses to their upper level management. Our current system will only make the problems worse.
The fact that they’re keeping fraudulent records and nothing will happen to them when private sector employees would be sued and jailed for healthcare fraud under otherwise same circumstances merely breeds more distrust in the VA system and in the people who run it.
]]>By: girlvethttp://www.epmonthly.com/whitecoat/2014/05/healthcare-update-satellite-05-21-2014/#comment-155300
Sun, 25 May 2014 22:15:22 +0000http://www.epmonthly.com/whitecoat/?p=9793#comment-155300As someone who has been a patient at the VA, I think they do a great job.

The VA has the same problems every other healthcare system has: trying to fits thousands of patients into a system that is not set up to cope with them.

Part of all of this is the guilt this country feels about basically paying a professional military to fight their wars for them. Its so much easier to get behind wars when your son or daughter doesn’t have to go.

]]>By: WhiteCoathttp://www.epmonthly.com/whitecoat/2014/05/healthcare-update-satellite-05-21-2014/#comment-154016
Wed, 21 May 2014 16:55:12 +0000http://www.epmonthly.com/whitecoat/?p=9793#comment-154016Point taken about “saving lives”. It really does become a game of semantics. Perhaps “postponing death” is a better descriptor.

The quote about “saving one life” was made in reference to school shootings. I don’t think we could use the same argument there. I was more into showing the irony about how we can take up one cause without any regard for costs or unintended consequences in order to “save” one life, but other causes that do not fit a specific agenda are cut to bare minimums regardless of the lives “lost” or the gravity of the unintended consequences.

Determining whether the screening would be a good use of healthcare dollars could be considered a philosophical dilemma. One one hand, saving expenditures of $10 billion per year would be a wise investment. However, on the other hand, if fewer people lived longer, then there would be fewer people using those healthcare dollars. Medicare would be insanely profitable if everyone paid into the system for 40 years or so then died at age 64 before they could utilize their benefits. Medicare loses money on patients who are chronically ill and live to be nonagenarians.

I think fairness requires that a country provide basal health care (not health *insurance*) for all of its citizens, not just the senior citizens, but that proposal would never fly.

The latter approach of overtly or covertly rationing care would be a morally suspect and politically dangerous position to take publicly … which is why the government is hiding all of the VA Hospital policies and refusing to release them in the wake of these scandals.

Would be a great topic for a philosophy lecture.

]]>By: Donhttp://www.epmonthly.com/whitecoat/2014/05/healthcare-update-satellite-05-21-2014/#comment-154006
Wed, 21 May 2014 15:57:27 +0000http://www.epmonthly.com/whitecoat/?p=9793#comment-154006Feds consider whether to spend billions of extra Medicare dollars to screen former smokers for lung cancer. Doing so could cut a high-risk patient’s chances of dying from cancer by 20%.
I remember someone in a position of leadership once saying that if we can save one life, it’s worth it. Therefore, spending this extra money should be a no-brainer.

Honestly, I think we have to consider if this screening really is a good expenditure of limited health care dollars. These are Medicare patients. For the most part, they are over 65. I know there are exceptions, but most of them are over 65.

We won’t save one life with screening for lung cancer. All we will do is move the cause of death from lung cancer to another column.

Medical science has yet to save anyone’s life. We will all die.

We would prefer that most of us die peacefully of old age, but we will all die.

If you told me spend $1 billion prescreening for lung cancer and we can reduce treatment costs from $20 billion per year to $10 billion per year, then I would agree that it is a no brainer. But if we are doing it “to save lives”, it isn’t worth it. Because we won’t be saving any lives.